Provider Demographics
NPI:1487629937
Name:ADAMS, J MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:MICHAEL
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:680 E FREMONT MEDICAL PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2309
Mailing Address - Country:US
Mailing Address - Phone:402-727-5200
Mailing Address - Fax:402-721-5230
Practice Address - Street 1:680 E FREMONT MEDICAL PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2309
Practice Address - Country:US
Practice Address - Phone:402-727-5200
Practice Address - Fax:402-721-5230
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE13034207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47053664512Medicaid
NE095014ADMedicare ID - Type Unspecified
NE47053664512Medicaid